<form class="form-horizontal well" method="post" action="<?php echo base_url(); ?>serviciosA/tratamiento" accept-charset="utf-8">
    <fieldset>
        <legend>Resultado de Examen</legend>

        <div class="row-fluid">   
            
            <div class="span7"> 
                
            <div class="control-group">
                <label class="control-label" for="paciente">Paciente</label>
                <div class="controls"><input type="text" disabled class="input-xlarge" id="paciente" style="border:none" value="<?php echo $mcodigo?>"></div>
            </div>
            
                
            </div>  
            
            <div class="span5"> 
                
             

            </div>
            
        </div>   
        
        
        
        <div class="control-group">
                  <label class="control-label" for="diagnostico">Resultados</label>                 
                   <div class="controls"><textarea class="span11" id="diagnostico" style="border:none" value="Masculino"></textarea></div>
        </div>
      
        
        <div class="form-actions">
            <button type="submit" class="btn btn-primary">Guardar y continuar</button>
            <button type="reset" class="btn">Finalizar</button>
            <button type="reset" class="btn">Guardar Imagen</button>
        </div>

    </fieldset>
</form>